Whos Most At Risk Of Shingles
People tend to get shingles more often as they get older, especially over the age of 70. And the older you are, the worse it can be. The shingles rash can be extremely painful, such that sufferers cannot even bear the feeling of their clothes touching the affected skin.
The pain of shingles can also linger long after the rash has disappeared, even for many years. This lingering pain is called post-herpetic neuralgia .
Is Shingrix Or Zostavax More Effective
Shingrix and Zostavax have both been proven to prevent shingles. However, Shingrix is a newer vaccine that is considered more effective than Zostavax. Shingrix is even recommended for those who have already received the Zostavax vaccine in the past.
Clinical trials have shown that Shingrix is 97% effective at preventing shingles in adults aged 50 to 69 years old. Shingrix is also effective in preventing shingles in older adultsadults over the age of 70, Shingrix is 91% effective.
Zostavax has a 70% efficacy rate in preventing shingles in adults aged 50 to 69 years old, according to the Zoster Efficacy and Safety Trial . Results from the Shingles Prevention Study showed that Zostavax is 51% effective against shingles. Compared to Shingrix, the effectiveness of Zostavax decreases in older age groups. Based on the SPS results, Zostavax is 64% effective in adults aged 60 to 69 years old 41% effective in adults aged 70 to 79 years old and 18% effective in adults aged 80 years and older.
Your healthcare provider will most likely recommend Shingrix over Zostavax. Shingrix is especially recommended for immunocompromised patients since it is a non-live vaccine. Ask your doctor or pharmacist about which shingles vaccine is right for you.
Should I Get A Vaccine
Doctors say most healthy people over 50 should get Shingrix, as well as anyone 19 or older who are immunocompromised. Itâs available at pharmacies as well as doctorsâ offices. Most people have been exposed to the chickenpox even if they didnât actually develop symptoms.
You should get the Shingrix vaccine unless:
- You are allergic to any part of the vaccine
- Had a blood test that proves you never had chicken pox
- Have shingles now
- Are breastfeeding or nursing.
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The Problem With Medical Records Tracking Vaccine Schedules
Another obstacle is the fact that it can be difficult for family physicians to know exactly what vaccinations a patient has received. Unlike pediatric patients, who typically have accessible records of their vaccination schedule, it can be trickier for adults.
For adults, it becomes quite challenging, especially when they switch providers, because often times you have to track down records to find out if theyve been vaccinated, said Jain.
She said it can be complicated to try and decipher which vaccines patients have received and which ones they should get without clear records.
For adults over the age of 65, you want to find out if theyve gotten the two pneumonia vaccinations that are recommended, so it becomes a challenge to find out if theyve gotten both, or just one, she said.
Same thing goes now for the shingles vaccination. Youre kind of tracking down records, and when you dont have them, you have to make a clinical judgment.
Despite these challenges, Jain says the fact that Shingrix is a newly minted vaccination may make things a bit more straightforward.
The nice thing about Shingrix is that its so new, most patients have not gotten it, she said. Even if theyve had Zostavax, its recommended that they get Shingrix in addition to it, so thats a little bit less of a challenge with a new vaccination.
What Does The Shingles Vaccine Do
The shingles vaccine can prevent shingles. Every year, about 1 million people in the United States get shingles. Anyone whos had chickenpox can get shingles. Thats because the varicella-zoster virus lives silently in your nervous system after you’ve had chickenpox. The virus can reactivate later in your life if your immune system is weakened. Your risk of getting shingles goes up as you get older. In the United States, 1 in 3 people will get shingles in their lifetime.
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Who Should Not Get A Shingles Vaccine
If your immune system is weakened for any reason, or if you have tuberculosis, you should not get a shingles vaccine. Its also not recommended if youre getting radiation or chemotherapy, or if youve had leukemia or lymphoma.
Those who are pregnant should not receive the shingles vaccine, and women should not plan on conceiving for at least three months after receiving the shot.
Some people may be allergic to some of the ingredients in the vaccine, such as gelatin. If youre not sure, or if you have any concerns, just speak with us. Well be glad to provide details to help you make the right decision.
Make A Plan To Get 2 Doses
- You can get Shingrix at your doctors office or pharmacy. Talk to your doctor or pharmacist about getting Shingrix.
- Plan to get your second dose of Shingrix 2 to 6 months after your first dose.
Five years later, I still take prescription medication for pain. My shingles rash quickly developed into open, oozing sores that in only a few days required me to be hospitalized. I could not eat, sleep, or perform even the most minor tasks. It was totally debilitating. The pain still limits my activity levels to this day.
A 63-year-old harpist who was unable to continue playing due to shingles
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What If I Wait Too Long To Take The Second Shingrix Dose
The Centers for Disease Control and Prevention state that if more than 6 months have passed since you received your first dose, you should get the second dose as soon as possible. You dont have to start the doses all over again.
Also, if you get the second dose within 4 weeks after the first dose, it should not be counted. You should get your follow-up dose at least 1 to 2 months after the first dose, per your doctors recommendation.
What Else To Know About The Shingles Vaccine
Ready to get vaccinated? This is the essential info on how the shots are given, what to expect with side effects, and more.
You need two doses of Shingrix to get full protection from shingles. You should get your second dose 2 to 6 months after the first. Your doctor or pharmacist will inject the vaccine into the muscle of your upper arm, so wear clothes that give easy access to that area.
If it has been more than 6 months since you got your first dose, go ahead and get your second dose. You donât need to start over, Dooling says.
Because Shingrix is so new, experts arenât sure whether youâll eventually need another shot, or a booster, years down the road.
âThe CDC is actively following how protected people remain after the two-dose series,â she says. We know that after 4 years, protection remains above 85%. Only time will tell how durable that protection is.â
You do not have to wait between Shingrix and COVID-19 vaccination. The CDC has determined its safe to get the COVID-19 vaccine at the same time as Shingrex, but recommends they be given in different arms. You should not get eithe vaccine if you have COVID.
Side effects are fairly common. You may have heard that people sometimes have unpleasant side effects soon after they get the shingles vaccine.
âShingrix tends to have has more side effects than some vaccines, like those for the seasonal flu,â says Kistler. The shingles vaccine may cause:
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What Are The Advantages Of Getting The Shingles Vaccine
The shingles vaccine reduces your risk of getting shingles. Shingles causes a painful rash that usually develops on one side of your body or face. Some people describe the pain as an intense burning or shooting sensation. The rash is often a single strip that wraps around one side of your body or is on one side of your face. It consists of blisters that normally crust over in seven to 10 days. The rash generally clears up within a month.
Some people with shingles also experience additional symptoms including fever, headache, chills or upset stomach.
For some people, the pain from the rash can last for months or even years after the rash goes away. This long-term pain is called postherpetic neuralgia , and it is the most common complication of shingles.
Who Can Have The Shingles Vaccination
Shingles vaccination is available to everyone aged 70 to 79.
When you’re eligible, you can have the shingles vaccination at any time of year.
The shingles vaccine is not available on the NHS to anyone aged 80 or over because it seems to be less effective in this age group.
Read more about who can have the shingles vaccine.
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Why More Adults Arent Getting The Super
Despite such impressive results, only about 35 percent of adults 60 and older reported receiving the shingles vaccine in 2018. Whats behind the hesitation? A couple of things. First, says Kristin Christensen, M.D., an internal medicine specialist affiliated with Penn Medicine, in Radnor, Pennsylvania, some of us dont take shingles as seriously as we should: People think, If its not going to kill me I dont need it, without realizing that singles can be incapacitating, causing severe pain that can really limit peoples functioning.
Whats more, difficulty in getting the vaccine may have discouraged those who sought out the vaccine earlier on. The company that makes the vaccine couldnt keep up with the initial demand, resulting in long waiting lists at pharmacies that dispensed the vaccines.
Then theres the hit to your wallet. Shingrix costs on average about $195 per injection, and two injections are required. But unlike the flu and pneumonia vaccines, which are fully covered as preventive services under Medicare Part B, the shingles shot falls under the prescription drug plan under Medicare Part D. Depending on your plan, even after youve met your annual deductible youll likely end up shelling out money for it. If youre between the ages of 50 and 65, and covered by a private health insurance, ask your doctor about getting your vaccine now, while youve got good coverage, Schaffner suggests.
How To Pay For Shingrix
Commercial insurance covers about 96% of insured people for the Shingrix vaccine. Most people with private insurance will pay under $5 for each dose.
Programs like Medicaid cover Shingrix in certain states. Medicare Parts A and B do not cover the shingles vaccine. But individuals covered under Medicare prescription drug plans, or Part D, will have their vaccines covered.
For people who do not have access to insurance, there are a number of vaccine assistance programs and affordable health coverage options available. Many of these programs provide vaccines at little or no cost.
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Personal Stories About Considering A Shingles Vaccine
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I talked to my doctor about the shingles vaccine and I think I’m going to get it. My wife had shingles 2 years ago, and she was really in a lot of pain. If I can avoid that by getting a vaccine, it will really be worth it to me.
Abel, 65
I’m not going to get a vaccine, at least not right now. I don’t like to take medicines of any kind if I don’t have to.
Hattie, 50
Reasons To Get The Shingles Vaccine
Once a person develops chickenpox after contracting the varicella-zoster virus, the virus never leaves the body. It remains dormant in the nerve roots and can reappear as shingles later in life.
The primary symptom of shingles is a painful rash on one side of the body, most often on the torso or face. People initially have pain or a burning sensation on the skin without a rash, and then painful blisters develop. The rash lasts approximately seven to 10 days and fully clears within two to four weeks.
The likelihood of developing shingles increases dramatically after age 50. Therefore, the Centers for Disease Control and Prevention recommends that all adults age 50 and over receive two doses of Shingrix to prevent shingles. The vaccine is recommended even if a person is unsure if they have ever had chickenpox.
People with weakened immune systems are at higher risk for shingles. Therefore, the Food and Drug Administration also recently approved Shingrix vaccination for adults age 18 and older who are at risk for shingles due to immunodeficiency or immunosuppression caused by an underlying disease or medication.
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Who Is A Candidate For The Shingles Vaccine
Healthy adults aged 50 years and older are candidates for the shingles vaccine Shingrix. There is no age limit, and you can get the Shingrix vaccine even if you have already had shingles, have had the Zostavax vaccine, or do not remember whether you have had chickenpox in the past.
If you have already had shingles, getting the Shingrix can help protect you from the disease coming back. Studies have reported that almost every American aged 40 years and older have more than a 99% chance of having had chickenpox, and people who have had chickenpox are more likely to develop shingles in the future because both are caused by the same virusthe varicella-zoster virus.
After having shingles, there is no duration that you need to wait before getting vaccinated, although you should wait until the rash has completely disappeared. Shringrix is given in 2 doses 2-6 months apart.
Side effects are usually mild and may last for two to three days. No severe side effects for Shingrix have been reported so far.
Administration In People With Hiv
The product information for Zostavax states that the safety and efficacy of Zostavax have not been established in adults with known HIV infection with or without evidence of immunosuppression.
ATAGI recommends that Zostavax may be given to people who have HIV but are not immunocompromised, after confirming pre-existing immunity to varicella-zoster virus.
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Obstacles To Getting Vaccinated
Despite the fact that the small, but vocal, group of individuals who oppose vaccinations remains strong, Jain says she hasnt encountered much opposition to getting vaccinated among her patients.
A lot of patients will actually come to me asking how they can get the shingles vaccination, so I actually have experienced the opposite, she said. Theres a very small percentage of patients, Id say under 10 percent, that are very averse to getting vaccinations, though.
Jain said that with these patients, their concerns often center around possible adverse effects from the vaccination, fears that theyll contract shingles by getting the vaccination, or the belief that since theyve never had the illness, they dont need the vaccine.
Another big concern that patients have is cost, Jain told Healthline in March 2018. Zostavax cost $213, and Shingrix costs about $280 out of pocket.
Prices have fluctuated slightly in 2019, with Shingrix at $185 per injection (.
She explained that even insurance or Medicare coverage doesnt solve the problem.
The issue is that Medicare Part B is not covering it, Medicare Part D is covering part of it, and Medicaid may or may not cover it it really depends on the insurer and the insurance plan, she said. So, I think cost is also a big barrier for patients as well.
When Should You Get Immunised Against Shingles
Anyone aged 60 years and over who wants to protect themselves against shingles can talk to their doctor about getting immunised.
Shingles immunisation is recommended for:
- adults aged 60 years and over who have not previously received zoster vaccine
- adults aged 70 years to 79 years, for free under the National Immunisation Program
- adults aged 50 or over who live in the same household as someone who has a weakened immune system.
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Who Should Not Have The Shingles Vaccine
You should not have the shingles vaccine if you’ve had a serious allergic reaction in the past to a previous dose of the shingles vaccine, or to any of the ingredients in the vaccine, or to a previous dose of varicella vaccine.
If you have a weakened immune system a GP or practice nurse will assess which vaccine is suitable for you. Discuss any health concerns with the GP or practice nurse before you have the vaccine.
Zostavax is not suitable for people who have a weakened immune system due to a condition, treatment or medicine.
Contraindications And Precautions For Shingles Vaccination
Zostavax should not be administered to:
- A person who has ever had a life-threatening or severe allergic reaction to gelatin, the antibiotic neomycin, or any other component of herpes zoster vaccine.
- A person who has a weakened immune system because of:
- HIV/AIDS or another disease that affects the immune system,
- treatment with drugs that affect the immune system, such as steroids,
- cancer treatment such as radiation or chemotherapy, or
- cancer affecting the bone marrow or lymphatic system, such as leukemia or lymphoma.
Someone with a minor acute illness, such as a cold, may be vaccinated. But anyone with a moderate or severe acute illness should usually wait until they recover before getting the vaccine. This includes anyone with a temperature of 101.3°F or higher.
This information was taken from the Shingles Vaccine Information Statement dated 10/06/2009.
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